Nurses with convictions for sexual offenses, drug thefts and crimes of violence have escaped detection under Colorado’s porous system for licensing health care workers, which has far fewer protections than most states.

Colorado is one of six states that does not conduct criminal background checks on applicants for nursing licenses. The state requires massage therapists and private investigators to submit a fingerprint for checks against state and FBI conviction records to get licensed. It’s even a step the legislature decided this year to require of operators of fantasy sports leagues before they set up shop in Colorado.

To identify dangerous applicants or licensees with criminal histories, the nurse licensing system in Colorado mostly relies on self-disclosure and complaints. The process allows nurses deemed unfit for the job in other states to obtain and hold a Colorado license to work as a nurse here or in other states.

Hospitals and other health-care employers in Colorado say they perform their own checks, yet workers with criminal backgrounds continue to find employment. Adding to the problem, hospitals that learn about a nurse’s criminal acts are not required to report them to the state licensing board, so the worker can find another hospital job.

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The Denver Post reviewed state nurse discipline records from 2010 to the present involving criminal activity. Among hundreds of records, The Post found dozens of cases in which nurses or applicants failed to reveal convictions and continued working, sometimes for years, as nurses in Colorado. At least seven had convictions for sexual crimes.

The number of nurses working with undisclosed convictions is likely much higher. The Post reviewed only those nurses whose criminal convictions eventually attracted the attention of the Colorado nursing board, sometimes after the nurse was convicted a second or third time or had been fired for misconduct.

“Any health care providers with access to highly addictive narcotics should have checks,” state Rep. Susan Lontine, D-Denver, who co-sponsored a bill this year that required background checks for surgical techs and assistants. “We should look at doing something.”

Cory Everett, a deputy director with the Colorado Department of Regulatory Agencies, said her department likely will ask legislators in the upcoming session for authority to conduct criminal background checks for nurse licensing but cautioned such checks will require additional resources. The department investigates criminal records when complaints against nurses are made, she said.

The Denver Post

Criminal checks for nurse licensing Forty states require fingerprint criminal records checks for nurses to be licensed. Four other states check state paper criminal records. Colorado does not require either.

CONVICTED FIVE TIMES

Provided by Department of Corrections

Richard Vernon Merritt was convicted at least five times, including for three sexual offenses, but had a nursing license in Colorado for more than a decade.

Richard Vernon Merritt, a self-described sex addict, would seem a bad fit for the nursing profession.

He has been convicted at least five times, including for three sexual offenses. He once posed as an undercover police officer to coerce a woman into giving him oral sex. He was convicted of exposing himself to two women. He used a stolen debit card to withdraw nearly $20,000 — a felony conviction that netted him three years of incarceration. When police in Florida once tried to arrest him, he attempted to drive through a police roadblock, sending officers scattering.

At least one nursing agency fired him after female patients complained he tried to pressure them to get together with him outside a hospital, a violation of the professional code of nursing.

“I made mistakes and crossed boundaries,” he said in an interview.

Florida, Virginia, Louisiana, California, North Carolina, Arizona, Connecticut, New York, Maryland and Georgia have blocked Merritt from holding a license for nursing.

Yet Colorado licensed Merritt in 1999. He was able to renew that license, a process that involves filling out a questionnaire, every two years until May 2013. Colorado officials finally learned of Merritt’s past transgressions after Maryland authorities received a complaint from a hospital there that Merritt was using his Colorado license to get work as a traveling nurse.

“I don’t know if they were just lackadaisical or if or if they just overlooked it,” Merritt said.

Merritt explained that he flew to Colorado in 1999 so he could fake residency to get licensed. He used that license and fake Social Security numbers to get work in Colorado hospitals and in health-care facilities in about 10 other states over a decade as a traveling nurse. Colorado is part of a 24-state compact that allows nurses licensed in one state to work in other states.

“All you need to do is supply a license that’s valid,” he said.

The Colorado nursing board revoked his license in May 2013, about two months after the Maryland hospital lodged a complaint there.

Colorado requires applicants seeking a nursing license to list convictions on their applications and, after they obtain a license, to divulge to the state nursing board any new felony convictions within 45 days. As the Merritt case shows, not everyone is honest.

Provided by Colorado Department of Corrections

Timothy Arthur Napier pleaded guilty of sexually assaulting a 12-year-old girl with developmental disabilities but did not disclose that guilty plea when he sought to renew his Colorado nursing license.

In April 2010, Timothy Arthur Napier, a former nurse in Colorado Territorial Correctional Facility in Cañon City, pleaded guilty to the felony sexual assault of a 12-year-old girl with developmental disabilities for inappropriate touching, but Napier didn’t disclose that conviction on the license renewal questionnaire he submitted to Colorado in June 2010.

Colorado officials did not know when they renewed Napier’s license that his probation officer had deemed Napier as having a moderate to high risk of re-offending. The nursing board did not find out about his conviction until it began investigating Napier after a long-term care insurer filed a complaint in October 2010. The insurer had fired Napier for forging assessments of potential purchasers of long-term care insurance the insurer hired him to conduct. The nursing board suspended Napier’s license in February 2011, about 10 months after his conviction, then revoked his license in October of that year.

Napier said he didn’t disclose his conviction to the nursing board because he knew doing so would prompt revocation of his license. He said he’s sure plenty of other nurses in Colorado hide convictions and believes Colorado needs to put in place criminal background checks for licensing to find out who they are.

“Anyway you look at it, there needs to be a fingerprint database check, period,” said Napier, who said he’s rehabilitated himself and believes he’s fit to work as a nurse again. “But people also should get a second chance.”

The state nursing board in 2006 began checking licensee names against the Colorado Sex Offender Registry annually. Colorado also relies on national nurse licensing databases to provide alerts when action is taken against a nursing license in other participating states. Despite those safeguards, nurses with troubled pasts still slip through in Colorado.

Two months after authorities in Wyoming charged Michael S. Carroll II with sexually abusing a 14-year-old female patient, Carroll showed up in Colorado. Carroll started working in March 2009 as a traveling nurse at Swedish Medical Center in Englewood, months before he had obtained a Colorado nursing license, records show. The Colorado nursing board sent him a letter of admonition for working without a license but took no formal action. Carroll pleaded guilty to felony sexual abuse in December 2009 in Wyoming. The Colorado nursing board suspended his license in February 2010 and revoked it seven months later. Records show he had been working that year as a nurse in Colorado through a staffing agency. A jury later convicted him of sexually abusing another 14-year-old girl he knew.

Nicole Williams, the spokeswoman for Swedish, said a routine audit by the hospital caught the licensing issue, which resulted in Carroll’s firing. She said the hospital’s hiring procedures include a background check by a third party and verification of credentials. She said his criminal charges weren’t picked up in that review because Carroll had been charged only 35 days before his hiring.

BACKGROUND CHECKS VITAL

Colorado finds itself out of step with most states. During the past decade, many have put in place fingerprint criminal records checks to screen applicants, identify criminal histories and flag legal problems that surface after an applicant is licensed. In 2005, the National Council of State Boards of Nursing, the trade group for state nursing boards, recommended that nursing boards check state and federal criminal backgrounds on applicants and licensees.

“Nurses provide services for vulnerable people, often of a personal and intimate nature, so it is in the public interest to determine that those seeking the authority to practice nursing are qualified to do so, including in the areas of behavior, attitude and conduct,” that council stated.

In 1998, only five states conducted criminal background checks on nurses; by 2014, 36 states required fingerprint criminal records checks, with an additional five requiring a review of state criminal records without any fingerprint submission. Other states are moving toward requiring such checks. Connecticut began requiring them for nurses in nursing homes and other long-term-care providers this year.

Kansas put in place fingerprinting for licensing in 2009. Data provided by that state shows the program found about 29 percent of nursing students with a criminal conviction seeking a license did not disclose that conviction.

Texas began fingerprinting nurse licensing applicants in 2003 and expanded the program to license renewals. In one instance, regulators found a nurse applying for a renewal did not disclose a murder conviction. Since 2006, reports of convictions and arrests are sent to the nursing board in that state, an enhancement that has generated about 8,000 alerts.

“It definitely fits right in with our mission to protect the public,” said Mark Majek, director of operations for the Texas nursing board.

Thomas Mark Moore, who surrendered his nurse license in Alaska in 2014 because of an undisclosed drunken driving conviction, kept an active nursing license in Colorado. Moore now faces felony criminal charges for alleged unlawful sexual contact with his drugged patients.

Thomas Mark Moore was able to find work in health care facilities after being fired amid accusations of sexual misconduct. His Colorado nursing license remained active until January even though Alaska authorities in March 2014 forced him to surrender his nursing license in Alaska because of an undisclosed drunk driving conviction. He has pleaded innocent to felony charges of unlawful sexual contact.

Nurses have greater access to narcotics and more contact with patients than surgical techs and assistants do. There also are many more nurses than surgical techs or assistants working in the state. As of July 2015, about 634 surgical assistants and 1,992 surgical techs were registered to work at Colorado hospitals. There are more than 81,000 registered and licensed practical nurses in Colorado.

The Colorado Nurses Association hopes criminal background checks will become part of the state’s practice act for nursing, which is up for renewal in 2017, said M. Colleen Caspar, the association’s executive director.

Without a change in law, it often rests upon law enforcement to notify regulators and hospitals about illegal activity by nurses.

Provided by Colorado Department of Corrections

Tiffany Malmgren was arrested and charged by Wheat Ridge police with using forged prescriptions to obtain the painkiller, Oxycontin, but Wheat Ridge authorities and Malmgren never notified the Colorado nursing board of that arrest.

Wheat Ridge police in June 2010 charged Tiffany Malmgren with allegedly using forged prescriptions to obtain nearly 406 days’ worth of the powerful painkiller OxyContin. When she submitted her nurse licensing renewal questionnaire a month later, she failed to disclose that arrest. Wheat Ridge authorities never notified the nursing board of her arrest because they never knew Malmgren was licensed, said David Pickett, a division chief with the Wheat Ridge Police Department.

“In this particular case, we just didn’t know,” Pickett said. “We probably need to get into a position where people who have significant control of the health and welfare of others have more routine and more thorough background checks.”

The Colorado nursing board didn’t learn Malmgren was fraudulently obtaining OxyContin until it received a complaint in April 2011 from another law enforcement agency after she pleaded guilty to a felony drug charge in another case. The Longmont Police Department had determined Malmgren had used multiple false names, birthdates and Social Security numbers to obtain about 3,171 tablets of OxyContin between December 2009 and June 2010 from 27 doctors. Her license was suspended in April 2011 and revoked months later, more than a year after her arrest by Wheat Ridge police. She has since died.

In one case, The Post found a nurse surrendered her nursing license in another state only to continue her nursing career in Colorado, where she ended up with numerous convictions.

Juanita Martinez, who was convicted of a felony welfare fraud charge in the 1990s, surrendered her nursing license in Wyoming in 2000 because of allegations she failed to adequately assess and document the condition of an elderly assisted-living patient who had fallen and later died. Matrinez obtained a nursing license in Colorado the same year she surrendered her license in Wyoming. The Colorado nursing board revoked her nursing license temporarily after learning she’d surrendered a license elsewhere, but then relented, and in 2002 allowed her to be licensed for nursing in Colorado on a probationary status. That probationary status eventually was lifted two years later, and she was allowed to practice as a nurse with no conditions.

“If the regulatory board shows more understanding and compassion, well after all they are nurses,” Martinez said. “The courts and all boards could learn a thing or two from them.”

Records show that the very year the Colorado nursing board gave Martinez a probationary license, police arrested her for allegedly trespassing on a neighbor’s property to steal a bed. She pleaded guilty of misdemeanor tampering.

In November 2008, Martinez pleaded guilty to resisting arrest. In April 2012, a jury convicted her of a felony trespass charge and of misdemeanor theft and tampering charges. In December 2012, she pleaded guilty again to violating a criminal protection order, obstructing a peace officer and driving while under the influence of alcohol.

She surrendered her Colorado nursing license in September 2013, more than 11 years after her first conviction in Colorado and about 13 years after she had surrendered her license in Wyoming for allegedly causing the death due to negligence. She said she plans to reapply for a Colorado nursing license.

“I’ve paid my debt to society,” Martinez said. “Is it necessary to turn around and make me not be productive for rest of my life now?”

In another case, Heather White pleaded guilty to felony ID theft charges in 2009 and was ordered to pay $65,000 restitution. She had been stealing funds from her husband’s medical practice, where she was employed as an office manager, to obtain controlled substances illegally for her own use. She also had been stealing prescription pads to fraudulently obtain prescription drugs. In 2012, her deferred sentence in that case was set aside after she pleaded guilty again and was placed on three years of probation in a new deferred arrangement to the original case.

She never notified the nursing board of the convictions within the 45 days as required.

In 2015, about six years after her conviction, the nursing board finally ordered her to undergo a substance abuse evaluation, which concluded in September 2015 that she was “not safe to practice as a nurse with reasonable skill and safety without monitoring.”

White, who did not return telephone messages seeking comment, remains a licensed nurse under the terms of an agreement with the nursing board that required her to enter into a treatment plan.

Christopher N. Osher is a reporter on the investigation team at The Denver Post who has covered law enforcement, judicial and regulatory issues for the news organization. He also has reported from war zones in Africa.

Since 2006, the nation’s largest police departments have fired at least 1,881 officers for misconduct that betrayed the public’s trust, from cheating on overtime to unjustified shootings. But The Washington Post has found that departments have been forced to reinstate more than 450 officers after appeals required by union contracts.